16 March 2012 6:07 PM

A dangerous precedent

A married couple have been awarded $2.9m compensation against a hospital in Oregon, USA, for the failure of a pre-natal test to detect Downs' syndrome in their child. They say that they would have aborted the child if they had known the diagnosis.

My younger son's only child has had physical and mental challenges since birth. It is not for me to say what any couple should or should not do. Nor will I comment on the life that my son, his wife and their child have had. However, from my former work as a GP, I do know the enormous strain that any family experiences when there is a physically or mentally challenged child.

This news story worries me for another reason. Where will it lead?

In some communities, will girl foetuses be aborted for no reason other than their gender? Under the terms of The Abortion Act, that is illegal. But does it happen even now?

The opponents of the law said at the time that it would in due course lead to de facto abortion on demand. We may support this or oppose it but does it happen already to some extent?

Most abortions are carried out on the basis that the mental life of the mother would be damaged if the pregnancy were to continue. That is not difficult to argue.

Two independent doctors have to sign the form that makes the abortion legal. Their independence might be questionable at times but that possibility was predictable from the start.

Now we have a new factor. In this particular case in Oregon, the family claimed that a test was performed inaccurately. It appears that a sample was taken from the mother rather than the foetus. That seems to be a straightforward mistake, with severe implications when it comes to litigation.

But supposing, in the future, it comes to be expected that all tests should be 100% accurate and all babies 'perfect'. If everything does not work out as hoped, doctors and hospitals might be sued if any congenital abnormality is not detected prior to birth.

Further, it might be expected that any defect detected in a foetus should lead to an abortion, if the parents demand it.

One way or another, the law of the country and the expectations of some families are taking precedence over the personal beliefs and principles of doctors. When doctors become merely an instrument of the State, or of the demands of individual patients, that in itself is a very dangerous precedent.

The new case, even though it occured in America, is an even more dangerous precedent for all gynaecologists and hospitals.

As pre-natal diagnosis becomes progressively more accurate, another clause in The Abortion Act may come to be the most frequent cause of abortions: concern for the health of the child.

If Downs' syndrome is sufficient justification today, how about other physical or mental problems, that may come to be detectable pre-natally, tomorrow? There is a long list of medical conditions that require lifelong care at some level. They present a huge challenge to parents and other carers. Yet many are happy to take on that responsibility.

Subsequently they often describe the richness that these children bring to their lives.

There is an even longer list of conditions that might be seen as 'wrong' in those seeking perfection in their offspring. At what point will the law draw the line? Or are we approaching the time when abortion on demand is not only permitted but even, by some people, expected for any clinical condition that differs from the norm? Eugenics has an ugly history.

Like other doctors, perhaps especially in the private sector, I have been on the receiving end of expectations, or even demands, by individuals that I should say or write or do things that I do not believe in. I have also been on the receiving end of expectations by the State that I should do things that I do not believe in, such as drug substitution in the treatment of addiction.

My concern for the future is that fear of litigation will lead to the subservience of doctors and ultimately to totalitarianism.

On the present issue, let us suppose that, at some time in the future, there is a doubt over the interpretation of a pre-natal test result. Might the doctor or hospital err on the side of personal and financial caution and recommend an abortion rather than risk being sued?

What sort of doctors is our society creating? History has shown that doctors who do not think and act for themselves are a very dangerous breed indeed.

Share this article:

Comments

You can follow this conversation by subscribing to the comment feed for this post.

Post a comment

Comments are moderated, and will not appear on this weblog until the moderator has approved them. They must not exceed 500 words. Web links cannot be accepted, and may mean your whole comment is not published.

DR ROBERT LEFEVER

Dr Robert Lefever established the very first addiction treatment centre in the UK that offered rehabilitation to eating disorder patients, as well as to those with alcohol or drug problems. He was also the first to treat compulsive gambling, nicotine addiction and workaholism.
He identified 'Compulsive Helping', when people do too much for others and too little for themselves, as an addictive behaviour and he pioneered its treatment.
He has worked with over 5,000 addicts and their families in the last 25 years and, until recently, ran a busy private medical practice in South Kensington.
He has written twenty six books on various aspects of depressive illness and addictive behaviour.
He now provides intensive private one-to-one care for individuals and their families.

He has written twenty six books on various aspects of depressive illness and addictive behaviour.

He now uses his considerable experience to provide intensive private one-to-one care for individuals and their families.